FDA’s rotten definition of “healthy” food is finally getting tossed

The US Food and Drug Administration on Wednesday proposed a long-awaited revision to the definition of the term "healthy" on food packaging—finally scrapping the mind-boggling criteria from the 1990s that made healthful foods such as nuts, salmon, avocados, olive oil, and even water ineligible for the label.

The new definition is not immune to criticism, and Americans are likely to still face uncertainty about healthy food choices as they stroll grocery store aisles. But, the proposed update—which coincides with this week's White House Conference on Hunger, Nutrition, and Health and a national strategy to improve US nutrition and reduce hunger—is a clear improvement.

Under the current criteria, established in 1994, the FDA allows food manufacturers to label their products as "healthy" based on myopic maximums and minimums of specific nutrients. That means "healthy" foods have universal maximums for saturated fat, total fat, cholesterol, and sodium and are also required to provide at least 10 percent of the daily value for one or more of the following nutrients: vitamin A, vitamin C, calcium, iron, protein, and fiber.

Under this rule, foods with loads of added sugars—like low-fat yogurts or sugary breakfast cereals aimed at children—are eligible for a "healthy" label because they meet the other qualifications. The same goes for some nutritionally questionable white breads. Yet whole foods such as avocados or currently recommended meats, like salmon, are ineligible due to fat content—flying in the face of current, evidence-backed healthiness of plant-based foods. And even plain water or plain carbonated water can't be labeled "healthy."

New rule

The absurdity of this definition made headlines in 2015 when the FDA sent a warning letter to the maker of Kind bars saying it couldn't use the term "healthy" on its nut-based bars because they had too much saturated fat. Nuts and seeds alone are generally ineligible for the "healthy" label under the current rule. The company pushed back and, in 2016, the FDA reversed course, saying that it planned to update the definition—which leads us to the proposed update this week.

Under the FDA's proposed rule—which could still change—the agency is now taking a more holistic approach to evaluate foods, saying that foods could be labeled healthy if they:

• Contain a certain meaningful amount of food from at least one of the food groups or subgroups (e.g., fruit, vegetable, dairy, etc.) recommended by the Dietary Guidelines.
•  Adhere to specific limits for certain nutrients, such as saturated fat, sodium, and added sugars.

Importantly, for this last point, the thresholds for the nutrient limits would vary based on the type of food or food group a product contains—i.e., an olive oil-based product has a higher saturated fat limit than vegetable-based products, which have a lower added sugar limit than grain-based foods. The FDA offered a useful table here on the proposed limits for different food groups.

The FDA also offered an example for a cereal that would meet the new "healthy" definition: It would "need to contain ¾ ounces of whole grains and contain no more than 1 gram of saturated fat, 230 milligrams of sodium, and 2.5 grams of added sugars."

The FDA is hoping that the change will help consumers select better foods at the grocery store and spur food manufacturers to adjust their products to fit the new definition.

The revision is "an important step toward accomplishing a number of nutrition-related priorities, which include empowering consumers with information to choose healthier diets and establishing healthy eating habits early," FDA Commissioner Robert Califf said in a statement. "It can also result in a healthier food supply."

Needed change

Such nutrition-related goals are more important than ever. On Tuesday, the Centers for Disease Control and Prevention reported data showing that the number of states with a high rate of adult obesity—defined as 35 percent of adults or more—has more than doubled since 2018. Nineteen states and two territories now have high rates. Childhood obesity has also climbed amid the pandemic. According to a study published in the Journal of the American Medical Association last year, the percentage of 5- to 11-year-olds in the category of "overweight" or "obese" rose from 36.2 percent in the year before the pandemic hit to 45.7 percent by January 2021.

Obesity at any age can set people up for serious health conditions, such as high blood pressure, sleep apnea, heart disease, stroke, Type 2 diabetes, some cancers, severe outcomes from COVID-19, and poor mental health. The top three causes of death in 2020 were heart disease, cancer, and COVID-19.

Of course, obesity is a complex, multi-factor health condition, and diet is only one part of it. But, there's plenty of data to suggest that people in the US are not eating well—and the quintessential American diet is feeding chronic health problems. The FDA notes that 75 percent of Americans have diets low in fruits, vegetables, and dairy; 77 percent get too much saturated fat; 63 percent eat too much added sugars; and a whopping 90 percent exceed the limit for sodium.

The FDA's new proposed definition for "healthy" certainly won't solve those problems in one fell swoop. Some health advocates and experts say it may have minimal effects and that package labeling that warns of unhealthy content—with things like red-light symbols—may be more effective than labeling "healthy" foods. But, the update is a clear improvement from the current definition of "healthy," which is not aligned with evidence-based dietary recommendations.

In a comment to The Washington Post, Kind CEO Russell Stokes said the company was celebrating the proposed update. "A rule that reflects current nutrition science and Dietary Guidelines for Americans is a win for public health—and that's a win for all of us."